Root canal filling materials and methods

ABSTRACT

In various embodiments of a method for filling root canal spaces, the root canal spaces are cleaned and irrigated, for example, by any suitable endodontic procedure, and the irrigating liquid is not removed from the canal spaces prior to filling. In some embodiments, a hydrophobic filler material is introduced into the root canal spaces while they are filled with liquid. As the canal spaces are filled, the hydrophobic filler material displaces the liquid and drives it out of the canal spaces, towards the crown of the tooth, where it can be removed. The hydrophobic filler material may comprise magnetically responsive particles having a hydrophobic surface coating that are compacted into the root canal spaces by application of a magnetic force field. In other embodiments, hydrophilic filler material in a flowable phase is introduced into the canal spaces where it partly displaces and partly absorbs the irrigating liquid before solidifying.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. §120 and 35 U.S.C.§121 as a divisional application of U.S. patent application Ser. No.11/752,812, filed May 23, 2007, entitled “ROOT CANAL FILLING MATERIALSAND METHODS,” which claims the benefit under 35 U.S.C. §119(e) of U.S.Provisional Patent Application No. 60/802,662, filed May 23, 2006,entitled “ROOT CANAL FILLING MATERIALS AND METHODS,” the entiredisclosure of each of which is hereby incorporated by reference hereinin its entirety.

BACKGROUND

1. Field

The present disclosure relates generally to filling spaces in a bodylocation and more particularly to filling root canal spaces in a tooth.

2. Description of the Related Art

Treatment of root canal spaces in a tooth typically involves removal oforganic material from the root canal spaces followed by filling thespaces with a filling material. Present filling materials arehydrophobic and may include gutta-percha, polymers, calcium hydroxide(Ca(OH)₂), and/or zinc oxide (ZnO) liners. Prior to filling the rootcanal spaces with these filling materials, the canal spaces typicallymust be widened, which is traditionally performed with hand- ormachine-driven endodontic files. To ensure proper adhesion of thefilling material to tooth dentin, moisture and fluids are evacuated fromthe canal spaces (such as by wicking or aspirating) prior to filling.Such evacuation of fluids commonly results in sucking organic componentsand contaminated fluids (e.g., pus, serum, and/or blood) from the apicalperiodontium through one or more canal orifices, which may causere-infection of the canal spaces. Due to these and other deficiencies,the overall success rate for the treatment is around 70 percent. Becauseof the uncertainty and the cost of the process, extraction of thediseased tooth is often used as a treatment alternative.

SUMMARY

An embodiment of an apparatus comprises a manipulator which produces anon-contacting force field to manipulate a filling material duringfilling of a root canal space of a tooth. The filling material maycomprise a plurality of particles responsive to the non-contacting forcefield. In some embodiments, the non-contacting force field may comprisea magnetic field.

An embodiment of a method for filling a root canal space of a toothcomprises using a non-contacting force field to manipulate a fillingmaterial during filling of the root canal space. In someimplementations, the non-contacting force field comprises a magneticfield, and the filling material magnetically interacts with the magneticfield.

An embodiment of a method of filling a root canal system of a toothcomprises compacting colloidally suspended discrete particles in a rootcanal to fill the canal with a substantially solid filling.

An embodiment of a root canal filler for a tooth comprises amultiplicity of relatively large particles sized to form a plug in acanal space proximate an apex of the tooth and a multiplicity ofrelatively small particles sized to at least substantially fill theremainder of the canal space.

An embodiment of a method for filling a root canal space of a toothcomprises plugging a canal space proximate an apex of the tooth andsubsequently at least substantially filling remaining space of the canalwith a flowable filling material.

An embodiment of a hydrophilic root canal filling material is provided.The filling material may be adapted to be introduced into a root canalspace when liquid is in the canal space during filling. The liquid mayprovide a barrier against migration of bacteria into an apical area ofthe tooth. When introduced into the root canal, at least a substantialportion of the liquid may be absorbed by the hydrophilic material.

An embodiment of a method of filling a root canal space of a toothcomprises introducing a hydrophobic material into a root canal space ofa tooth when a liquid substantially fills the root canal space. Theliquid may provide a barrier against migration of bacteria into anapical area of the tooth. The liquid may be substantially displaced fromthe root canal space by the hydrophobic material.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a cross section schematically illustrating a typical humantooth, which in this example is a molar.

FIG. 2A schematically illustrates an embodiment of an endodontictreatment for filling the root canal spaces of the tooth.

FIG. 2B is a cross-section view schematically showing an exampleendodontic method for cleaning a root canal system of a tooth, in whicha high-velocity jet is directed toward a dentinal surface through anopening in the crown of the tooth.

FIG. 3 schematically illustrates an embodiment of a micromanipulatorcomprising a stylus having a magnetic tip. FIG. 3 schematically depictsexample magnetic field lines near the tip.

FIG. 4 schematically illustrates a root canal filling method using themicromanipulator of FIG. 3 to magnetically guide magnetically responsivefiller material into the canal spaces of a tooth.

FIG. 5 schematically illustrates another embodiment of a filling methodusing a matrix of electromagnetic coils to produce a magnetic fieldgradient near a tooth (shown in the inset).

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

The present disclosure describes various materials and methods forendodontic treatments that overcome possible disadvantages associatedwith conventional root canal treatments. In certain embodiments of amethod for filling root canal spaces, the root canal spaces are cleanedand irrigated (e.g., by any suitable endodontic procedure), and theirrigating liquid is not removed from the canal spaces prior to filling.In certain such embodiments, the method comprises introducing ahydrophobic filler material into the root canal spaces while they arefilled with liquid (e.g., water). As the canal spaces are filled, thehydrophobic filler material displaces the liquid and at least partiallydrives the filler material out of the canal spaces, towards the crown ofthe tooth, as will be described more fully below.

In some embodiments, the hydrophobic filler material comprises a colloidof coated ferromagnetic particles (and/or other material that isresponsive to a magnetic field). The coating advantageously may comprisea substantially hydrophobic substance. By way of example, the coatingmay comprise polyorganosiloxanes, polyorganosilanes, or mixturesthereof. For convenience, the magnetically responsive particles will bereferred to hereinafter as “mag-particles.”

FIG. 1 is a cross section schematically illustrating a typical humantooth 10, which comprises a crown 12 extending above the gum tissue 14and at least one root 16 set into a socket (alveolus) within the jawbone 18. Although the tooth 10 schematically depicted in FIG. 1 is amolar, the material and methods described herein may be used on any typeof tooth such as an incisor, a canine, a bicuspid, or a molar. The hardtissue of the tooth 10 includes dentin 20 which provides the primarystructure of the tooth 10, a very hard enamel layer 22 which covers thecrown 12 to a cementoenamel junction 15 near the gum 14, and cementum 24which covers the dentin 20 of the tooth 10 below the cementoenameljunction 15.

A pulp cavity 26 is defined within the dentin 20. The pulp cavity 26comprises a pulp chamber 28 in the crown 11 and one or more root canalspaces 30 extending toward an apex 32 of each root 16. The pulp cavity26 contains dental pulp, which is a soft, vascular tissue comprisingnerves, blood vessels, connective tissue, odontoblasts, and other tissueand cellular components. The pulp provides innervation and sustenance tothe tooth through the epithelial lining of the pulp chamber 26 and theroot canal space 30. Blood vessels and nerves enter/exit the root canalspace 30 through a tiny opening, the apical foramen 34, near a tip ofthe apex 32 of the root 16.

FIG. 2A schematically illustrates one embodiment of an endodontictreatment for filling the canal spaces 30 of the tooth 10. A drill orgrinding tool is initially used to make an opening 40 in the tooth 10.The opening 40 may extend through the enamel 22 and the dentin 20 toexpose and provide access to pulp in the pulp cavity 26. The opening 40may be made in a top portion of the crown 12 of the tooth 10 (as shownin FIG. 2A) or in another portion such as a side of the crown 12 or inthe root 16 below the gum 14. The opening 40 may be sized and shaped asneeded to provide suitable access to the pulp cavity 26 and/or all ofthe canal spaces 30. In some treatment methods, additional openings maybe formed in the tooth 10 to provide further access to the canals 30and/or to provide dental irrigation.

The pulp cavity 26 and/or the canal spaces 30 may be cleaned andirrigated by any suitable method. For example, in some procedures,endodontic files are inserted into the root canal system to open thecanal spaces 30 and remove organic material therein. An effective methodfor cleaning the root canal system is depicted in FIG. 2B, whichschematically illustrates a high velocity collimated jet 52 of liquid(e.g., water) directed through the opening 40 toward a dentinal surface54 of the tooth 10. In some embodiments, the high-velocity liquid jetmay have a velocity in a range from about 50 m/s to about 300 m/s andmay have a transverse size (e.g., diameter) in a range from about 1micron to about 1000 microns.

Impact of the jet 52 causes acoustic energy to propagate from the impactsite on the dentinal surface 54 through the entire tooth 10, includingthe root canal system. The acoustic energy is effective at detachingsubstantially all organic material in the root canal system fromsurrounding dentinal walls. The acoustic energy may be effective atcleaning the root canal system, because the acoustic energy generatesacoustic cavitation effects (e.g., cavitation bubbles, cavitation jets,acoustic streaming, entrainment, etc.), which efficiently detach and/ordelaminate organic material from dentinal surfaces and tubules. Thetreatment time during which the high-velocity jet 52 is directed towardthe tooth 10 may range from about 1 second to about 120 seconds invarious cleaning methods.

In many embodiments, the detached organic material can be flushed fromthe root canal using an irrigation fluid (e.g., water). In someembodiments, liquid from the high-velocity jet provides the irrigationfluid. In other embodiments, a low-velocity jet or stream provides theirrigation fluid. The liquid jet 52 may be directed from a handpiece 50that can be manipulated within a patient's mouth by a dentalpractitioner. In certain endodontic procedures, the high velocity liquidjet 52 is directed into the pulp cavity 26 and/or the root canal spaces30 to excise and/or emulsify organic material therein. The liquid jet 52may be generated by a high pressure compressor system or by a pumpsystem in various embodiments. Further details of apparatus and methodsfor generating the high velocity jet 52 and using the jet 52 to cleanroot canal systems are found in U.S. patent application Ser. No.11/737,710, filed Apr. 19, 2007, entitled “Apparatus and Methods forTreating Root Canals of Teeth,” which is hereby incorporated byreference herein in its entirety.

In certain preferred embodiments, after cleaning the canal spaces 30,irrigating liquid 42 (e.g., water) is not removed from the canal spaces30 prior to filling. The irrigating liquid 42 advantageously may act asa vector for any floating particles and/or organic material and as abarrier against the influx of periapical fluid (e.g., through the apicalopening 34). Filling material 44, such as the hydrophobic fillingmaterial described herein, may then be applied to the canal spaces 30.As the canal spaces 30 are filled, the hydrophobic filler material 44displaces the irrigating liquid 42 and forces the liquid 42 at leastpartially out of the canal spaces 30, toward the opening 40 in the crown12 of the tooth 10 (or toward any other suitable opening formed in thetooth 10).

In certain embodiments, the filler material 44 comprises a sterilecolloid comprising mag-particles. The filler material 44 may be providedto a dental practitioner in standard 1.8 milliliter dental cartridges.In a preferred embodiment schematically illustrated in FIG. 2A, thecolloid is applied to the canal spaces 30 using a standard cartridgesyringe with an injection needle 50 such as, for example, a steriledisposable 30-gauge short injection needle. In some procedures, thecolloid is applied into the canal spaces 30 without pressure and withoutbinding the injection needle 50 to the walls of the canal space 30,which advantageously may reduce application of pressure to the liquid 42present in the canal space 30 and may allow the liquid 42 to bedisplaced from and escape the canal space 30. In the example methoddepicted in FIG. 2A, the needle 50 has been used to apply the fillermaterial 44 to a portion of the canal space 30 a. After filling thecanal space 30 a, the dental practitioner may fill other spaces in thetooth 10, such as the canal space 30 b. Although depicted as straight inFIG. 2A, the needle 50 may be bent and/or curved to access portions ofthe canal spaces 30 a, 30 b. In some embodiments, portions of the needle50 may be flexible.

In certain embodiments, a force field is used to manipulate the fillermaterial during the filling of the canal spaces 30. The force fieldadvantageously may be a non-contacting force field that applies a forceto the filler material without physically contacting the material. Forexample, the force field may comprise a magnetic force field, and thefiller material may comprise a substance that is responsive to themagnetic force field.

As schematically illustrated in FIG. 3, the magnetic force field may beapplied using a micromanipulator comprising a stylus 60 having amagnetic tip 62. FIG. 3 schematically depicts example magnetic fieldlines 64 near the tip 62. In other embodiments, the magnetic field lines64 may have a different configuration and/or polarity than shown in FIG.3. For example, the magnetic field lines 64 may have a configurationthat includes components such as dipole, quadripole, and/or higher ordermultipole components. In some methods for filling root canal spaces, themagnetic tip 62 of the stylus 60 is positioned near the tooth 10 andmoved toward the apex 32 adjacent to the tooth root 16. FIG. 4schematically illustrates application of the tip 62 of the stylus 60 tothe canal space 30 a of the tooth 10. The magnetic tip 62 may be movedtoward the apex 32 one or more times during a treatment. The magneticfield of the tip 62 may provide an attractive force that urges themag-particles in the canal space 30 a towards the apex 32 untilsubstantially all the canal space 30 a is filled, and the mag-particlesare condensed in the canal space 30 a. As the mag-particles arecondensed, the liquid 42 in the canal spaces 30 is squeezed outward dueto the hydrophobic surface property of the coating material of themag-particles. This procedure may be repeated for the canal space 30 ineach root 16 of the treated tooth 10. Surplus colloid can be removedfrom the access opening 40 and coronal pulp chamber 28.

In some methods, the mag-particles are also condensed in the canalspaces 30 using an endodontic spreader such as, for example, a No. 1dental hand-spreader and/or plugger (e.g., a. Schilder spreader) so asto form a substantially solid core 70 of mag-particles in the canalspaces. The substantially solid core 70 is schematically illustrated inthe canal space 30 b shown in FIG. 4. The resulting core 70advantageously may be substantially bacterio-static, substantiallytissue compatible, and not substantially affected by tissue metabolism.The core 70 of mag-particles also may be substantially radio-opaque. Thefilled canal spaces 30 may be sealed over in a conventional manner, suchas with a bonded restorative material.

In certain preferred embodiments, mag-particles of different sizes areused in the filling process. In order to reduce the likelihood thatmag-particles migrate through the apical opening 34 of the tooth 10 intosurrounding vascularized tissue, larger mag-particles may be introducedfirst into the canal spaces 30, followed by introduction of smallermag-particles. The larger mag-particles advantageously may have a sizethat allows the mag-particles to migrate proximate to the apical opening34, but not through the apical opening 34. The magnetic tip 62 of thestylus 60 may be used to assist condensing the larger and/or the smallermag-particles in the canal spaces 30. In certain embodiments, themag-particle coating is somewhat compliant such that the coatings candeform as magnetic attraction from the stylus 60 pulls them through theroot canal towards the apex 32 and into progressively smaller spaces. Itis beneficial if the coating is not so compliant as to deform to a sizesmaller than that of the apical opening 34 (typically, 30 microns). Asan example, in certain embodiments, the size of the larger mag-particlesmay be in a range from about 35 to about 200 microns, more preferably ina range from about 40 to 100 microns, and even more preferably in arange from about 50 to 70 microns. The larger mag-particles may thusadvantageously be used to form a plug in a portion of the root canalspace 30 adjacent the apex 32 of the tooth 10. The mag-particles formingthe plug may be compacted using the magnetic field of the stylus 60 andmay bond to each other by diffusion of the coating material.

In certain preferred embodiments, following creation of the plugcomprising the larger mag-particles, smaller size mag-particles areintroduced into the canal spaces 30. By way of example, the size of thesmaller mag-particles may be in a range from about 2 to 30 microns, morepreferably in a range from about 2 to 15 microns, and even morepreferably in a range from about 2 to 5 microns. In certain suchpreferred embodiments, the mag-particles are sufficiently small toreadily fill the small side canals, fins, and narrow spaces thattypically extend laterally from the main root canal spaces 30. In somemethods, the smaller mag-particles are compacted by means of themagnetic field and bond to each other by diffusion of the coatingmaterials, thereby creating a rigid volume of filling material thatfills the root canal system.

Various micromanipulators may be utilized to magnetically guide themag-particles to targeted sites using magnetic force fields. Embodimentsof the micromanipulator may use a magnetic force to guide themag-particles by application of an attractive force, a repulsive force,and/or a combination thereof to pull and/or to push the mag-particlestoward the targeted sites. In some embodiments, the micromanipulator isconfigured to provide a suitable magnetic force gradient to guide themag-particles. By way of example, the micromanipulator may comprise astylus (such as the stylus 60 described above) having a tip 62 thatcomprises one or more magnets or electromagnets. The one or more magnetsmay comprise rare earth (e.g., neodymium) magnets, In anotherembodiment, the micromanipulator comprises a plurality of coils forminga matrix of electromagnets. When suitably energized, the electromagneticmatrix of coils creates temporal and/or spatial electromagnetic fieldvariations (statically or dynamically) to provide electromagnetic fieldpatterns and field gradients that increase or optimize the force (and/orforce gradient) applied to the mag-particles. The force gradient may beused to control the degree of mag-particle compactness and also toprevent the filler material 44 from reaching unwanted areas (e.g., theapical opening 34).

In certain treatment embodiments, some of the mag-particles are guidedby the micromanipulator to assist moving surrounding filling materialinto small cracks, holes, crevices, channels, and/or spaces in the rootcanal system. For example, movement of the mag-particles may cause someof the surrounding fluid and/or filler material to flow due to acoupling force between the mag-particles and the fluid and/or fillermaterial. The coupling force may comprise, for example, friction,viscosity, etc. In some methods, a time varying force field (and/orforce gradient) is applied to the mag-particles to cause such a flow.The fluid motions induced by the movement of the mag-particles mayassist introduction of filler material into the smaller root canalspaces.

In some embodiments, the electromagnetic matrix is in the form of astrip 80 that is mounted on the head of the patient with theelectromagnetic matrix in proximity to the apex of the tooth or teethunder treatment, as illustrated schematically in FIG. 5. The matrix maybe powered by a power-supply that is controlled by a computer ormicroprocessor. The power supply drives the matrix of coils selectivelyunder the control of computer software to create a magnetic-fieldgradient in the manner of a magnetic phased array. As schematicallydepicted in FIG. 5, the magnetic field gradient may be configured toprovide a positive region 84 of attractive magnetic field to the rootcanal system, while providing a negative region 88 of zero or repulsivemagnetic field near the apical openings 34 of the tooth 10 undertreatment. The matrix may be spatially calibrated to the location of theapical openings 34, so that the field gradient generated by the matrixis precisely located with respect to the tooth 10 under treatment anddraws the mag-particles through the canal system, but not through theapical openings 34. Accordingly, the electromagnetic matrix maypreferably be attached to the patient in a manner that prevents orinhibits relative motion between the matrix and the tooth 10 undertreatment when the magnetic field is applied. Such attachment may beaccomplished by means of a helmet (e.g., for upper teeth), a jaw clamp(e.g., for lower teeth), or by clamping the matrix to one or more teethadjacent the tooth 10 under treatment.

The matrix of coils may be used not only to move the mag-particles, butalso to sense movement of the mag-particles. For example, as themag-particles fill the root canal system, the mag-particles will crossmagnetic field lines produced by the matrix, which generates a directcurrent (DC) in the coils. By measuring the DC current (and/or voltage)in each coil, relative movement between the mag-particles and the tooth10 under treatment may be calculated. In some embodiments, the relativemotion of the mag-particles is output on a display for viewing by thedental practitioner. In such embodiments, the dental practitioner mayobserve in real-time the migration of the mag-particles into the rootcanal system and the mag-particles' location relative to the apicalopenings 34. To provide increased control over the filling treatment,the magnetic field intensity, gradient, spatial and/or temporalconfiguration may be altered in accordance with the sensed movement. Inan alternative embodiment, the matrix of coils provides a low intensityfield for sensing movement without moving the particles, and themagnetic field that moves the particles is applied by a micromanipulatorsuch as a handheld stylus manipulated by the dental practitioner (e.g.,the stylus 60 shown in FIG. 3).

In some methods, after the filler material 44 comprising themag-particles has sufficiently cured, energy is applied to heat thefiller material 44 above the melting point to at least partially liquefythe filler material 44 and/or the mag-particles. The applied energy maycomprise electric, magnetic, and/or electromagnetic energy such as, forexample, from an applied electric field and/or magnetic field. In someembodiments, the applied energy comprises electromagnetic energy (e.g.,ultrasound). The at least partially liquefied material may then solidifyinto a substantially solid core within the root canal system of thetreated tooth.

In some cases, it may be desirable for the substantially solid core ofmag-particles to be removed (e.g., re-treatment of the tooth 10) In sometreatment methods, the core may be at least partially liquefied byapplication of energy to the affected tooth. As described above, theapplied energy may comprise electric, magnetic, and/or electromagneticenergy. For example, ultrasound energy may be applied, e.g., with aCavitron® instrument available from Dentsply International, York, Pa.The liquefied core material can be suctioned or irrigated out of thecanal spaces 30.

In other embodiments of methods for filling root canal spaces, thefilling material may comprise a hydrophilic material such as, forexample, a protein-based, reversible hydrocolloid. Protein-basedreversible hydrocolloids are thermoplastics, which may liquefy in atemperature range above about 80 to 95 degrees centigrade and maysolidify in a temperature range below about 40 to 45 degrees centigrade.Liquefaction and solidification temperature ranges may be different indifferent hydrocolloids. When in a liquid phase, reversiblehydrocolloids may be able to absorb several times their volume of water.To avoid substantial changes in the physical properties of thehydrocolloid, in some methods water absorption is limited to about 30%of the volume of the hydrocolloid. Advantageously, the filling materialmay further comprise at least one bacterio-static substance, as well asat least one substance to provide radio-opacity. The filling materialmay comprise both a hydrophobic material (e.g., mag-particles) and ahydrophilic material (e.g., a reversible hydrocolloid) in someembodiments.

In certain method embodiments, the hydrophilic filling material issupplied in sealed 1.8 ml dental cartridges suitable for use in dentalsyringes. To liquefy the filling material, the cartridges may be placedin a heated liquid (e.g., hot or boiling water) for a liquefaction timethat is about 10 minutes for some hydrocolloids. After the fillingmaterial is sufficiently liquefied, the cartridge can be placed in acartridge syringe fitted with a suitable needle, for example, a 30 gaugeshort needle.

To deliver the filling material to the root canal system, the needle maybe curved and/or bent to access the canal spaces 30 in the tooth 10under treatment In certain preferred embodiments, the needle is placedwithout binding into the canal space 30, and a suitable amount ofliquefied filling material is injected into the space 30 to partiallyabsorb and/or partially displace liquid in the canal space 30. It may bedesirable in some embodiments for enough water from the canals 30 to bedisplaced such that no more than about 30% of the water is absorbed bythe hydrocolloid filler (e.g., at least about 70% of the water isdisplaced). By introducing a suitable amount of liquid reversiblehydrocolloid into the canal spaces 30, the hydrocolloid may helpmaintain the liquid stage of filler material previously introduced intothe canal spaces 30, may help maintain application of pressure, andthereby may help transport the filler material to the apex 32 and tosubstantially all the canal spaces 30 before the filler materialsolidifies. The filled canal spaces 30 may be sealed over in aconventional manner with a bonded restorative material.

As described above, in some methods, after the filler material hassufficiently cured, energy is applied to heat the filler material towardor above the melting point to at least partially liquefy the fillermaterial (and/or mag-particles if used). The at least partiallyliquefied material may help fill the canal spaces 30 and may helpprovide a substantially uniform core of material in the root canalsystem. The applied energy may comprise electric, magnetic, and/orelectromagnetic energy such as, for example, from an applied electricand/or magnetic field. In some embodiments, the applied energy compriseselectromagnetic energy (e.g., ultrasound). The at least partiallyliquefied material may then solidify into a substantially solid corewithin the root canal system of the treated tooth.

Although the tooth 10 depicted in the figures is a molar, one ofordinary skill in the art will appreciate that the procedures may beperformed on any type of tooth such as an incisor, a canine, a bicuspid,or a molar. Also, the disclosed methods are capable of filling rootcanal spaces having a wide range of morphologies, including highlycurved root canal spaces which are difficult to fill using conventionaldental techniques. Moreover, the disclosed methods may be performed onhuman teeth (including children's teeth) and/or on animal teeth.

The foregoing description sets forth various preferred embodiments andother illustrative but non-limiting embodiments of the inventionsdisclosed herein. The description provides details regardingcombinations, modes, and uses of the disclosed inventions. Othervariations, combinations, modifications, equivalents, modes, uses,implementations, and/or applications of the disclosed features andaspects of the embodiments are also within the scope of this disclosure,including those that become apparent to those of skill in the art uponreading this specification. Additionally, certain objects and advantagesof the inventions are described herein. It is to be understood that notnecessarily all such objects or advantages may be achieved in anyparticular embodiment. Thus, for example, those skilled in the art willrecognize that the inventions may be embodied or carried out in a mannerthat achieves or optimizes one advantage or group of advantages astaught herein without necessarily achieving other objects or advantagesas may be taught or suggested herein. Also, in any method or processdisclosed herein, the acts or operations making up the method/processmay be performed in any suitable sequence and are not necessarilylimited to any particular disclosed sequence. Accordingly, the scope ofeach of the inventions disclosed herein is to be determined according tothe following claims and their equivalents.

1. (canceled)
 2. A root canal filler for a tooth, comprising: amultiplicity of relatively large particles sized to form a plug in acanal space proximate an apex of the tooth; and a multiplicity ofrelatively small particles sized to at least substantially fill theremainder of the canal space.
 3. The root canal filler of claim 2,wherein sizes of the relatively large particles are in a range fromabout 35 microns to about 200 microns.
 4. The root canal filler of claim2, wherein sizes of the relatively small particles are in a range fromabout 2 microns to about 30 microns.
 5. The root canal filler of claim2, wherein at least some of the relatively large particles or therelatively small particles comprise a ferromagnetic core substantiallysurrounded with a hydrophobic coating.
 6. The root canal filler of claim5, wherein the hydrophobic coating comprises polyorganosiloxanes,polyorganosilanes, or a mixture thereof.
 7. The root canal filler ofclaim 2, wherein the multiplicity of relatively small particles is sizedto at least substantially fill side canals and other canal spacesextending laterally from the canal space.
 8. (canceled)
 9. (canceled)10. (canceled)
 11. (canceled)
 12. A system comprising: a fillingmaterial comprising a plurality of particles responsive to anon-contacting energy field, said filling material configured to atleast partially fill a root canal space of a tooth; and a manipulatorconfigured to produce the non-contacting energy field and to manipulatethe filling material without physically contacting the filling materialduring filling of the root canal space of the tooth, the non-contactingenergy field comprising electric energy or ultrasound energy, themanipulator configured to be positionable near the tooth and to providesufficient non-contacting energy to at least partially liquefy at leastsome of the filling material in the root canal space.
 13. A method forfilling a root canal space of a tooth, comprising: using anon-contacting energy field to at least partially liquefy a fillingmaterial in a root canal space during filling of the root canal space,wherein the non-contacting energy field comprises electric energy orultrasound energy.
 14. The root canal filler of claim 2, furthercomprising a hydrophilic material.
 15. The root canal filler of claim14, wherein the hydrophilic material comprises a reversiblehydrocolloid.